How corona has made regular delivery a googly

Child delivery in the time of Covid-19 has become a major operation. It requires the same protocols adopted in case of a delivery involving a woman suffering from hepatitis B & C or HIV.

TNN

April 04, 2020, 06:49 IST

New Delhi: Child delivery in the time of Covid-19 has become a major operation. It requires the same protocols adopted in case of a delivery involving a woman suffering from hepatitis B & C or HIV.

This is being done to avoid the risk of transmission of the novel coronavirus, said Dr Anuradha Kapur, director and head of the Institute of Obs and Gynae at Max Super Specialty Hospital, Saket. “We wear protective apron, masks, eye shields and vinyl gloves to protect ourselves from contracting the infection while conducting the delivery. All these personal protective equipment (PPEs) are then discarded,” she added.

The novel coronavirus can spread from an infected individual through respiratory droplets sent into the air when an infected person coughs or sneezes. It may also spread when someone touches a surface or an object that has the virus on it, then touches his mouth, inside of nose, or eyes.

Dr Amita Shah, consultant gynaecologist at Columbia Asia Hospital, Gurgaon, said even asymptomatic persons could be the carriers. “It is difficult to rely on contact history shared by patients. So, as a matter of abundant precaution, we are using PPEs for all child deliveries,” she said.

Normally, for a child delivery through caesarean section, two junior doctors, two technicians and multiple other staff are present, in addition to the gynaecologist. However, these days, the staff inside the operation theatre are kept at bare minimum because PPEs are available in limited numbers. “We don’t allow many relatives to visit the patient too. The practice of allowing the husband during the delivery has been restricted too,” said Dr Ranjana Sharma, senior consultant obstetrician and gynaecologist at Apollo Hospital.

If the mother is symptomatic for Covid-19, she added, breastfeeding cannot be allowed immediately and the baby is kept at a distance. Also, the doctors said, general anaesthesia is being avoided for caesarean section as it involves intubation and spinal anaesthesia is preferred.

Instead of monthly check-ups, pregnant women are asked to stay indoor and not to come unless an ultrasound is essential, said Dr Shah. “We are talking and consulting on WhatsApp video calls and allaying their anxieties,” she said, adding that around 50 deliveries had been conducted in March.

According to the World Health Organization (WHO), at present there is no evidence that pregnant women are at a higher risk of severe illness due to Covid-19 than the general population. “However, due to changes in their bodies and immune systems, pregnant women can be badly affected by some respiratory infections,” it says, adding that they should, therefore, report possible symptoms, even fever and cough, to their doctor.

Till now there is also no evidence on whether an infected pregnant woman can pass the virus to her foetus or baby during pregnancy or delivery. “To date, the virus has not been found in samples of amniotic fluid or breast milk,” WHO says.

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